K Number
K080932
Date Cleared
2008-06-09

(68 days)

Product Code
Regulation Number
878.4810
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The MOSAIC Laser System is indicated for use in dermatological procedures requiring the coagulation of soft tissue.

Device Description

The MOSAIC Laser System consists of a self-contained console, an optical fiber delivery system and a footswitch. The MOSAIC produces a beam of coherent infrared (1550 nm) light. The physician can optimize the effect for different applications by controlling the power of the laser pulse and using a different handpiece tip (5 mm, 6 mm, 8 mm, and 10 mm). The system console is the heart of the MOSAIC Laser System and contains the optical system (Er-GLASS Fiber Laser Module), Touch LCD, handpiece, system control module with an embedded processor, and power supply module. The main console also includes a key switch used to turn the power on and off, an emergency stop push button that quickly de-energizes the system in emergency situations, and the Touch LCD.

AI/ML Overview

The provided 510(k) summary for the Lutronic Corporation MOSAIC Laser System (K080932) indicates that the device's performance was established through a comparison to a predicate device rather than through specific acceptance criteria and a standalone human factors study or a multi-reader, multi-case study.

Here's an analysis of the provided information:

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance CriteriaReported Device Performance
Not specified"similar histological effects as the predicate device"

2. Sample size used for the test set and the data provenance

The document does not specify a distinct "test set" in the sense of a clinical trial with a defined sample size. The "performance data" mentioned refers to histological effects, likely from pre-clinical testing or animal studies, but the specific sample size, data provenance (country of origin), or whether it was retrospective or prospective is not provided.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable. The ground truth for the "similar histological effects" would typically be established by a pathologist reviewing tissue samples. However, no details on the number or qualifications of such experts are provided in this document.

4. Adjudication method for the test set

Not applicable. No information is provided regarding an adjudication method.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, and the effect size of how much human readers improve with AI vs without AI assistance

No, a multi-reader multi-case (MRMC) comparative effectiveness study was not performed. This device is a laser system, not an AI-assisted diagnostic tool, so such a study would not be applicable.

6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done

No, a "standalone" study in the context of an algorithm's performance was not done. The device is a physical laser system, and its performance is evaluated based on its physical and biological effects.

7. The type of ground truth used

The type of ground truth used was histology for assessing "similar histological effects."

8. The sample size for the training set

Not applicable. This device is a laser system, not a machine learning algorithm. Therefore, there is no "training set" in the context of artificial intelligence.

9. How the ground truth for the training set was established

Not applicable. As there is no training set for an AI algorithm, no ground truth needed to be established for it.

{0}------------------------------------------------

K080932

pg 1 of 2

510(k) Summary for the Lutronic Corporation MOSAIC Laser System

JUN - 9 2008

This 510(k) Summary is being submitted in accordance with the requirements of the SMDA 1990 and 21 CFR 807.92.

1. General Information

Submitter:Lutronic Corporation#403-2,3,4, Ilsan Technotown1141-1 Baeksok-Dong, Ilsan-GuGoyang-Si, Gyeonggi-Do, 410-722Republic of Korea
Contact Person:Maureen O'ConnellO'Connell Regulatory Consultants, Inc.5 Timber LaneNorth Reading, MA 01864Telephone: 978-207-1245Fax: 978-824-2541
Summary Preparation Date:March 31, 2008
2.Names
Device Name:MOSAIC Laser System
Classification Name:Laser Instrument, Surgical, PoweredProduct Code: GEXPanel : General & Plastic Surgery

3. Predicate Devices

The MOSAIC Laser System is substantially equivalent to a combination of the MOSAIC Laser System (K070392) and the Fraxel II SR Laser System and Accessories (K062303).

4. Device Description

The MOSAIC Laser System consists of a self-contained console, an optical fiber delivery system and a footswitch. The MOSAIC produces a beam of coherent infrared (1550 nm) light. The physician can optimize the effect for different applications by controlling the power of the laser pulse and using a different handpiece tip (5 mm, 6 mm, 8 mm, and 10 mm).

{1}------------------------------------------------

K080932

pg 2 of 2

The system console is the heart of the MOSAIC Laser System and contains the optical system (Er-GLASS Fiber Laser Module), Touch LCD, handpiece, system control module with an embedded processor, and power supply module. The main console also includes a key switch used to turn the power on and off, an emergency stop push button that quickly de-energizes the system in emergency situations, and the Touch LCD.

5. Indications for Use

The MOSAIC Laser System is indicated for use in dermatological procedures requiring the coagulation of soft tissue.

Performance Data 6.

Performance data was supplied which showed that the device has similar histological effects as the predicate device.

{2}------------------------------------------------

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of an eagle or bird-like figure with three curved lines representing its wings or feathers.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUN - 9 2008

Lutronic Corporation % O'Connell Regulatory Consultants, Inc. Ms. Maureen O'Connell Regulatory Consultant 5 Timber Lane North Reading, Massachusetts 01864

Re: K080932 Trade/Device Name: MOSAIC Laser System Regulation Number: 21 CFR 878.4810 Regulation Name: Laser surgical instrument for use in general and plastic surgery and in dermatology Regulatory Class: II Product Code: GEX Dated: May 12, 2008 Received: May 13, 2008

Dear Ms. O'Connell:

We have reviewed vour Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28. 1976. the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set

{3}------------------------------------------------

Page 2 - Ms. Maureen O'Connell

forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Center for Devices and Radiological Health's (CDRH's) Office of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance. please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at (240) 276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at (240) 276-3464. You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours.

Mark M. Millman

Mark N. Melkerson Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

{4}------------------------------------------------

K080932

pg \ of 1

Indications for Use
510(k) Number (if known):K080932

Device Name:

Indications for Use:

The MOSAIC Laser System in indicated for dermatological procedures requiring the coagulation of soft tissue.

Prescription Use X (Part 21 CFR 801 Subpart D) AND/OR

Over The Counter Use (Part 21 CFR 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Neil R.P. Ogden
Page 1 of 1
(Division Sign-Off)

Division of General, Restorative, and Neurological Devices

510(k) Number K080982

§ 878.4810 Laser surgical instrument for use in general and plastic surgery and in dermatology.

(a)
Identification. (1) A carbon dioxide laser for use in general surgery and in dermatology is a laser device intended to cut, destroy, or remove tissue by light energy emitted by carbon dioxide.(2) An argon laser for use in dermatology is a laser device intended to destroy or coagulate tissue by light energy emitted by argon.
(b)
Classification. (1) Class II.(2) Class I for special laser gas mixtures used as a lasing medium for this class of lasers. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 878.9.